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CMC to end mask requirement Feb. 28

Colorado Mountain College students, faculty and staff will no longer have to wear masks on campus starting Feb. 28, according to a news release.

College leadership decided to end the requirement after looking at immunity rates among faculty and staff, declining COVID-19 transmission and positivity rates, improving capacities at health care centers and public health plans within the communities the college system serves.

CMC has campuses across the High Country, including its Vail Valley campus in Edwards. The college plans to release more detailed information about COVID-19 protocols by Feb. 21.

Summit County to implement mask mandate

Shoppers wear masks Aug. 10 at City Market in Breckenridge. Summit County’s newest mask mandate will be in place starting Thursday, Dec. 30. The mandate is for all indoor public spaces.
Tripp Fay/For the Summit Daily News

As of Thursday, Dec. 30, Summit County will once again have a mask mandate.

Due to skyrocketing COVID-19 case numbers, an emergency Summit County Board of Health meeting was held Wednesday, Dec. 29, to discuss a new recommendation from Summit County Public Health Director Amy Wineland. During that meeting, Assistant County Manager Sarah Vaine told the board that Wineland recommended a mask mandate in public indoor spaces.

According to the county’s website, the incidence rate over the past seven days was 1,828 cases per 100,000 people. The state’s incidence rate for Summit County, which is reported as more than 20,000 cases per 100,000 people, is since the beginning of the pandemic, meaning about 20% of residents have tested positive for the virus since March 2020.

Vaine kicked off the meeting in Wineland’s absence — she was reportedly on a call with the Colorado Department of Public Health and Environment — and listed the reasons for why the county had been slow to implement such a measure thus far.

To start, Vaine noted that most exposures are coming from large, indoor gatherings. While masks are an effective tool against the virus, limiting indoor events has a bigger impact in slowing case rates. Vaine also pointed to other counties, such as Pitkin, that have had mask mandates in place for months while simultaneously reporting high case rates.

Vaine further pointed out that a mask mandate is enforced by front-facing staff, such as employees of retail shops, restaurants and bars. These are often the individuals who have to ask customers to wear a mask, and it’s these staff members who face the brunt of criticism and frustrations.

Vaine said it’s this feedback and concern that has acted as a primary factor for not reinstating a mask mandate thus far.

Summit County Commissioner Tamara Pogue said that over the past week, she’s gotten lots of feedback from community members both in support of and against a mask mandate. While she said she’s sympathetic to the extra burden a mask mandate would place on front-facing staff, she is still in support because of the surge in cases.

“Summit County and other resort communities are frequently ahead of the bell curve. … What that means is, I think, that likely in a week to 10 days, we will see the same kinds of staffing shortages we’re seeing in Summit County throughout the state,” Pogue said. “That means that while we are currently enjoying some capacity in our hospital, while we are currently enjoying some extra testing capacity that other communities may not be getting, it is likely we’re not going to see that in a week or 10 days out.”

Vaine noted that the county currently has three testing sites supplied by the Colorado Department of Public Health and that Wineland is advocating for more resources. It was noted during the meeting that wait times for a test were as long as three hours.

During the meeting, Vaine confirmed the county’s hospital capacity isn’t of concern. She said St. Anthony Summit Hospital does not have a single patient with COVID-19 but that the alarmingly fast rise in cases coupled with how much of the community’s workforce must quarantine is enough to worry public health leaders.

“When we set that, we also didn’t understand how quickly omicron would spread,” Vaine said about the county setting hospital capacity as a determining factor in implementing restrictions. “And so when we see the number of shortages of staff and the rapid spread of the virus — even though it doesn’t seem to be, at this point, as deadly or cause as critical illness as delta did — it’s still wiping out workforce in record numbers, and that’s really important to all of us,” Vaine said.

It’s because of this that Summit County Commissioner Elisabeth Lawrence said she was supportive of a mandate. She said the measure is meant to protect locals, some of whom have said they have tried to avoid grocery stores by ordering through curbside pickup. But because of staffing issues, this service isn’t offered, and when they go to the store, many customers are not masked.

“To me, it’s just a really commonsense approach and something we need to take to help mitigate this, even if it’s minuscule in what it does,” Lawrence said. “It also provides a level of comfort for our locals.”

Summit County Commissioner Josh Blanchard was in agreement with Lawrence and Pogue, and he noted that he supports public health measures that support businesses, and right now, those are measures that protect staff.

“This will allow for consistent messaging across the county,” Blanchard said. “We’ve seen some businesses that have taken on themselves by the recommendation of public health to implement mask restrictions within their own businesses, and this will allow for some consistent messaging, especially for our visitors who want to do the right thing.”

The new mandate takes effect Thursday, Dec. 30, and is only applied to public indoor spaces. Lawrence said the board would likely reconvene next week to discuss how long it’ll be in place. Vaine said the county would also have resources on its website regarding signage for businesses.

There is currently no discussion of capacity restrictions or other measures.

The trouble with Mind Springs: Summit, Eagle counties are breaking from their mental health provider and others are taking notes

Travis Bickford and his 6-year-old son, Trent, grocery shop in Breckenridge. Trent doesn't remember his mom, Jackie, who took her life when he was 5 months old. Travis blames Mind Springs for his wife's suicide.
RJ Sangosti/The Denver Post

Summit County is hurting.

The suicide rate in this mountain community of 31,000 is higher than Colorado’s, which is one of the highest in the nation. And locals say almost everyone here has known someone — or several someones — who ended their life:

A beer brewer. A prominent businesswoman. A bird-watching construction worker. A knitter of fabulous afghans. High school and middle school students.

A girl who was a baby when immigration officials deported her mom. Her name was Vanessa. She was 11.

“It has been a very personal public health crisis for us, and it is devastating,” says Summit County Commissioner Tamara Pogue.

She and other local leaders have tried to reduce risk factors in a county where the cost of living is high, wages low and the hospitality and outdoor industries’ workforces young, hard-partying, transient and separated from support systems. They have sought to combat mental health stigma, which nearly 64% of residents here cite as the reason they don’t seek counseling or other treatment.

Now they are trying to root out what they see as two other threats to the community’s mental health:

“F—ing Mind Springs, for one thing,” says Summit County Sheriff Jaime FitzSimons, whose jail — like many others — is full of people with untreated behavioral health conditions. “And that f—ing snake oil saleswoman who runs it, for another.”

Mind Springs Health, led by CEO and President Sharon Raggio, is the private nonprofit responsible for providing behavioral health safety-net services in Summit and nine other Western Slope counties: Eagle, Garfield, Grand, Jackson, Mesa, Moffat, Pitkin, Rio Blanco and Routt. It is one of 17 regional “community mental health centers” statewide that long have been responsible for inpatient hospitalization, intensive outpatient treatment, outpatient psychiatric care, counseling and other forms of treatment for Coloradans on Medicaid or who are indigent, underinsured or in crisis.

Mind Springs has been responsible for providing mental health safety-net services in the 10 counties outlined in red. This past summer, Eagle County became the first community statewide to split off from its community mental health center, with officials there saying Mind Springs has failed to meet the needs of county residents. Eagle has created its own center, which Summit County plans to join.
Colorado News Collaborative/Courtesy map

A recent Colorado News Collaborative investigation found that many of those mental health treatment centers are failing to serve the most vulnerable Coloradans. Mind Springs stands out among them for intense community disappointment about access to and the quality of its care. Nowhere is that disappointment expressed so bitterly and publicly than in Summit County.

Frustrations here are so high that in 2018, voters passed a tax measure to fund mental health care, even though it meant they are essentially having to pay twice for similar services. Since then, local officials have worked with the state to end three of Mind Springs’ contracts with Summit County. And now they are going a step further by severing ties altogether and joining nearby Eagle County’s new community mental health center because leaders in both counties say the state cannot — or will not — fix problems with Mind Springs.

The split marks the first of its kind in the 50-year history of Colorado’s mental health safety-net system, and is prompting other Mind Springs’ communities to question the safety-net provider and eye ways to take control of their own care.

Raggio, in a series of interviews over several months, has not addressed specific reasons for public discontent, telling the Colorado News Collaborative, “I don’t believe in litigating issues in the media.”

“It makes me sad that anybody would feel that they got less than adequate services from our organization,” she says. “It makes me sad that people have such negative things to say.”

Sharon Raggio, CEO and president of Mind Springs Health, has drawn criticism, especially among county officials in her center's West Slope coverage area. Among the complaints: long wait times, low quality of care, and not disclosing where and how her organization has been spending tax dollars.
Dean Humphrey/Courtesy photo

The new mom

Travis Bickford doesn’t want to hear it. Raggio’s words will not bring back what he says Mind Springs — from its clinics to its hospital to its services in the county jail — took from his family.

His wife, Jackie Bickford, 31, had a history of depression and alcohol addiction when she sought treatment at the Mind Springs office near their home in Breckenridge in 2016. She was experiencing severe postpartum depression after the birth of their son, Trent, a few months earlier. The clinic prescribed medication that her husband says seemed to make her more depressed and “turn her into a zombie.”

“The doctors there just handed that s— out like it was candy,” Travis Bickford said. “They would chastise her for overusing the medicine, but then keep refilling her prescription.”

Because she was talking about ending her life, he and his father-in-law had her committed to the Mind Springs-owned West Springs psychiatric hospital in Grand Junction. He says his wife returned home after about 10 days “far worse” than when she went in: “Constant crying, depression, abusing medicine, drinking vodka.”

He was at work one day in April 2016 when a nurse called their home for a wellness check. Police responding to the nurse’s concern found Bickford drunk and semiconscious with her infant son nearby, and arrested her on suspicion of child abuse and neglect.

Her family made the tough decision not to bail her out, assuming she — and Trent — would be safer if she were in jail where Mind Springs had a contract to provide mental health services. She threatened to kill herself if her son was removed from her care, so the jail clothed her in a smock that kept her from hurting herself and put her on a 24/7 suicide watch.

Within a day, Jackie Bickford persuaded a Mind Springs clinician to clear her to move off suicide watch and into a regular cell among the jail’s general population. Four days later, she killed herself.

Travis, Trent and Jackie Bickford on their way back from Mind Springs' psychiatric hospital in 2016. Travis says it was their last day together as a family.
Travis Bickford/Courtesy photo

Her family unsuccessfully sued the sheriff’s department, one of its officers and Danielle Wood, the Mind Springs clinician who had evaluated her. During a deposition, the family’s lawyer asked Wood whether, in retrospect, she wished she had not cleared Bickford to be taken off of suicide watch.

“No,” she answered.

“Why is that?” the lawyer asked.

“Because I did what was presented to me during her evaluation. She was not suicidal at the time,” Wood said.

How to get help

If you’re experiencing a mental health crisis, call the Colorado crisis hotline at 844-493-TALK (8255). There is no wrong reason to reach out.

Wood called Bickford’s suicide an “impulsive decision,” even though records show she had been suicidal for weeks — and even the day — leading up to it. Wood also claimed that Bickford’s husband had told her that his wife had improved in the hospital and was not suicidal.

Travis Bickford winces when reading Wood’s testimony.

“It’s hard enough that I lost my wife, that Trent lost his mom because we were desperate to get Jackie help and these f—ing people didn’t do their jobs,” he says. “But to sit here knowing this woman blatantly lied to justify her wrongdoing, to have no recourse after we made it perfectly clear Jackie was suicidal and tried like hell to make them help her, well, that takes crazy to a whole new level.”

The Colorado News Collaborative reached out to Wood and asked if she could provide any written notes of her claimed conversation with Travis Bickford. A Mind Springs spokesman says Wood declined to do so or to comment on his allegation.

Trent, now 6 and with no recollection of his mother, walks into the room and sees his father crying during an interview. He climbs on the kitchen counter and grabs a paper towel to wipe away the tears.

“It’s OK,” he tells his dad. “I know.”

Travis Bickford of Breckenridge has been raising his 6-year-old son, Trent, alone since the suicide of his wife, Jackie Bickford, in 2016. He blames Mind Springs Health for her death.
RJ Sangosti/The Denver Post

‘Please don’t call Mind Springs’

Summit County’s sheriff at the time, John Minor, announced his resignation to become police chief in Silverthorne a few weeks after Bickford’s suicide. Commissioners appointed FitzSimons, a commander in the department, to replace Minor until voters elected him to the office months later in 2016.

He inherited the legal aftermath of Bickford’s death — and county residents’ deep distrust of their community mental health center.

“When we’d come across people experiencing crises, they’d half the time say, ‘Oh my God, please don’t call Mind Springs. I won’t talk to them. They’re horrible,’” FitzSimons says.

He and other Summit County officials grew especially impatient with Mind Springs’ mobile crisis response unit. The state-funded program is supposed to dispatch a mental health specialist to people in crisis at any hour to help stabilize them so they don’t end up in more expensive emergency rooms. Assistant County Manager Sarah Vaine says she inquired about the program when noticing the number of ER visits wasn’t dropping, only to be told by a Mind Springs supervisor in Summit County that the organization was urging clients to go to the ER because it didn’t want to risk the safety of its mobile response team members.

Mind Springs’ spokeswoman, in response, writes, “There is a delicate balance between a crisis worker’s personal safety and responding appropriately to a crisis in someone’s home.”

Officials and private mental health care providers in five other counties within Mind Springs’ service area also describe their local mobile crisis response units as unresponsive.

Raul De Villegas-Decker, a clinical psychologist in Grand Junction, where Mind Springs is headquartered, says the unit there would call the primary care practice where he worked asking what it could do for someone in crisis.

“It was almost laughable — not the call you would expect from the very people who are paid to know how to handle crises,” he says.

Gwen Eller, a school counselor in Mesa County, adds that she and her colleagues were told by the school district not to count on Mind Springs’ mobile crisis unit in a crisis.

Even Mind Springs’ own staff members say they have problems getting the response units to show up.

“There’s typically nothing mobile at all about our mobile crisis team. It’s just basically a call center. And when you call, they act almost like you’re inconveniencing them,” says a Mind Springs clinician, who asked not to be identified for fear of being fired. “Here you have someone who is literally at the lowest point of their life, and they’re reaching out or having someone else reaching out for them, and what are we offering them? Nothing, which is terrifying.”

Summit County Sheriff Jaime FitzSimons doesn't mince words in his criticisms of Mind Springs Health. He has yanked its contracts to provide crisis response in his community and mental health services in his jail.
RJ Sangosti/The Denver Post

FitzSimons says his officers would respond to a call about a person actively trying to end their life and phone Mind Springs’ mobile crisis team for support, as was their protocol.

“They’d ask our deputy if he took their gun away, and the deputy would say ‘yes,’ and they’d say well, then there’s no need to send their people out because the problem had been solved.”

Raggio says her organization responds appropriately to crises as needed, but she declines to discuss any particular incident raised in this story.

The CEO, who made $312,331 in 2019, cites a lack of state and federal funding and a maze of red tape as challenges for Mind Springs. But more often than not, the former licensed professional counselor keeps returning to her own history leading Mind Springs from the verge of bankruptcy with “three days’ cash on hand” in 2008 to building a psychiatric hospital in 2018 and women’s recovery center in 2020. In almost all her interviews with the Colorado News Collaborative, she has mentioned the multiple business innovation awards the organization has won from industry groups.

“So I care deeply about community mental health,” she says.

“We’ve done a lot of good things,” she adds. “I know there are naysayers and that makes me sad. I think we all want the same things and can achieve more working together.”

Summit County Commissioner Tamara Pogue has worked to fill in gaps in mental health care left by Mind Springs, the local community mental health center.
RJ Sangosti/The Denver Post

‘A black hole’

Mind Springs’ critics, county officials, former clients — even its own employees — say that it’s not just mobile crisis units that seem to be MIA.

How much tax money the center receives for its programs, what it spends in each county, how many people it employs in each county are questions the center can’t or won’t answer. Entire programs seem not to exist. Spanish-language services are sorely lacking, even in areas with high immigrant populations.

“Mind Springs is a black hole,” says Pogue, the Summit County commissioner.

“We don’t know where the money goes or how it is being spent,” adds Beth Melton, a Routt County commissioner with similar concerns about Mind Springs. “It seems to me that we should have an understanding of what services are being provided in the community.”

Mesa County Commissioner Janet Rowland, who has a background in social services, also has questions about how Mind Springs is using state and federal tax dollars. She says Raggio keeps giving different explanations for barriers to care. “I’ve heard money’s an issue. I’ve at other times heard capacity or staff or state rules and regulations are the issue. We haven’t gotten to a real answer about what’s getting in the way.”

Raggio, who refers to herself as “an open book,” repeatedly has said her organization does not keep its electronic records in a way it could figure out how much it spends per county.

“That’s a lie,” says Vaine, the assistant Summit County manager.

In response to our initial investigation published earlier this month, Mind Springs’ spokeswoman Stephanie Keister contradicted Raggio, saying her colleagues do in fact keep records by county and would make them available for review. As of this writing, she has not provided them.

“If I owned a used car lot, I’d hire Sharon,” says FitzSimons, who slams Mind Springs for creating programs he says don’t deliver.

“For some reason, our state just gives them the money to keep doing it,” FitzSimons said.

Alex Wolfe, 22, has spent years in and out of treatment at Mind Springs for borderline personality disorder. He says he nosedives when its clinic runs out of or forgets to order an injection he needs to stabilize his mood.
RJ Sangosti/The Denver Post

Alex Wolfe, a 22-year-old Summit County resident, has spent years cycling in and out of treatment for borderline personality disorder. In 2018, he did a stint in Mind Springs’ psychiatric hospital from which he and his mother say he was released on the condition that he attend a certain kind of therapy group offered only at 5:30 p.m. each Wednesday.

“I went in at that time. They said come back next Wednesday. I went in again. They said there’s no such group,” he says.

Spanish speakers, whose cultures have especially high stigma around mental health, have an even tougher time accessing care at Mind Springs. In paperwork the nonprofit filed to receive state contracts, it describes its treatment as “culturally responsive.” Yet, Mind Springs usually does not have fluent Spanish-language providers in most of its clinics, including those in communities with sizable immigrant populations, such as Summit, Eagle and Routt counties. Sources in all three say the bilingual clinicians it has hired typically don’t last longer than a few months.

Mind Springs cites a statewide behavioral health workforce shortage for its difficulty finding and keeping bilingual care providers.

Fernando Almanza, a 911 dispatcher and school board member in Eagle County, says that stigma, in addition to Mind Springs’ lack of bilingual care, have dissuaded Latino residents there from relying on the center:

“It’s not trusted in the community, to say the least,” Almanza said.

Trust in Mind Springs’ home county of Mesa also is low. In two separate Mesa County surveys, one to residents and one to health care providers, respondents warned people to stay away from the center.

One provider wrote, “The saying is, you might as well commit suicide than go to Mind Springs because they will drive you to it.”

The Colorado News Collaborative interviewed more than 100 people about Mind Springs. The only praise came from someone who works in its hospital and from three self-identified clients who appeared in one of the organization’s marketing videos. We could not locate any of the clients who provided those positive testimonials.

Patti Casey, center, is pictured with her two daughters, Betsy Casey, left, and Lindsay Vitalis. Patti Casey, a prominent Summit County businesswoman, died by suicide in January 2016.
Casey family/Courtesy photo

Building Hope

Prominent Summit County businesswoman Patti Casey took her life by suicide in January 2016. By that year’s end, so had 12 other county residents, a pattern that prompted Casey’s family to launch a mental health care nonprofit in her memory.

Building Hope Summit County quickly drew widespread support for its mission of reducing mental health stigma, increasing access to treatment for Spanish — and English — speakers, and addressing other local behavioral health challenges. Community members rallied around that mission and proposed a mill levy to pay for mental health services Mind Springs wasn’t providing.

Building Hope says that, in less than three years, it has used about $2 million in revenues to help more than 1,800 county residents who either don’t have insurance or have a deductible they can’t afford to pay for up to 12 therapy sessions. Those are with 71 mental health care professionals independent of Mind Springs, many of whom are bilingual. Building Hope has been working to train those clinicians on how they can qualify to accept Medicaid reimbursement from the state. That training defies decades of efforts by Mind Springs and the Colorado Behavioral Healthcare Council, the trade group for community mental health centers, to limit the number of private Medicaid care providers they see as competition.

Jennifer McAtamney, executive director of Building Hope, discusses mental health care in Summit County on Sept. 17, 2019. Building Hope is a nonprofit organization in Summit County that works to promote better mental health.
Liz Copan/Summit Daily News archives

Revenues from Summit County’s mill levy also have allowed Building Hope to fund a program offering medication for addiction; pay for peer support counseling, which research shows can be more successful in communities with high levels of stigma; and staff teams of mental health coordinators to “concierge” or Sherpa people through various stages of treatment, to advocate for them with Mind Springs’ staff, and to help them find a bed in a psychiatric ward, if needed. Finding a local placement is important because Mind Springs’ hospital in Grand Junction is three hours away, often full and generally doesn’t treat children.

“People who have been screwed over so badly by the system just needed to have their health honored the way we do for other people who are sick,” says Jennifer McAtamney, Building Hope’s executive director.

Community leaders initially had feared the public would balk at having to pay twice — through federal and state tax dollars, then the local mill levy — for mental health safety-net care. Now, residents there seem to agree that the community cannot “be held hostage with substandard care,” says Vaine, Summit’s assistant county manager. She kicked Mind Springs’ detox program out of a county-owned building last year, then ended Mind Springs’ contract for that service and worked to prod the state to fund a different nonprofit to run it.

Likewise, Sheriff FitzSimons has ended Mind Springs’ jail and mobile crisis response contracts and replaced them with programs of his choosing. “At first, we didn’t know we could say ‘no’ to Mind Springs,” FitzSimons says. “But now I’ve got sheriffs all over the state calling to learn how to break from community mental health centers that aren’t getting the job done.”

Assistant Summit County Manager Sarah Vaine long has sought information about what services Mind Springs is and isn't providing in her community. The center hasn't provided clear answers.
RJ Sangosti/The Denver Post

If Summit County leaders have been the most vocal critics of Mind Springs, leaders in nearby Eagle County have — far more quietly — been the most aggressive in breaking off from the center.

Following Summit’s lead, Eagle County in 2018 passed its own mental health tax — on marijuana sales. Responding to what County Manager Jeff Shroll says are the same problems other counties have experienced with Mind Springs, his county then went a step further by forming its own community mental health center, called Eagle Valley Behavioral Health. The new nonprofit is a subsidiary of Vail Hospital, which will likely build a psychiatric hospital as well as a shorter-term overnight facility to stabilize people in crisis. It will include a team of clinicians co-responding to crises with law enforcement, a detox program and all the other safety-net services expected by the state.

Shroll says his county chose to avoid the kind of slow, painful split that has made Summit County have to fight for its share of state and federal mental health dollars.

“We haven’t gotten into the weeds with Mind Springs like other counties — you know, adversarial,” he says.

Leaders in Summit County are now working with those in Eagle County and with state behavioral health administrators to fully split from Mind Springs and join the new center.

The creation of the state’s 18th community mental health center — the first new one in several decades — challenges the status quo of Colorado’s mental health safety-net system. The new center will not be joining the Colorado Behavioral Healthcare Council, the powerful trade group that represents all other centers throughout the state in contract negotiations and has lobbied against proposals requiring competitive bidding for mental health contracts, and more transparency and accountability among the centers. Its creation also will take tens of millions of state and federal tax dollars annually out of Mind Springs’ pocket.

Raggio says she has a great relationship with Eagle County officials and initially denied knowing anything about their plans to split from Mind Springs.

“You’re the only person I’ve ever heard that from. Am I misinformed? I don’t know what to say about it,” she said in August. By that point, sources inside and outside her organization tell the Colorado News Collaborative she had been having conversations about the breakup and how to respond to it for at least six weeks.

Months later, Raggio put out statements welcoming the new center and announcing that she will be retiring this spring. The two developments are unrelated, she said in November before turning the conversation once again to the industry awards Mind Springs has won.

Officials in all but one of the eight counties remaining in Mind Springs’ coverage area have said that political and economic factors make it unlikely their voters would pass a tax to pay for mental health services the center is supposed to be delivering. The one exception is Pitkin County, where Aspen is located.

Meanwhile, Mesa County has been researching ways to possibly end some of Mind Springs’ contracts there.

“We’re trying to determine which is the best path forward. We definitely are looking at creating some programs — maybe detox, maybe crisis care — that would meet the need that remains unmet,” says Rowland, the Mesa County commissioner. In the meantime, she adds she would like to see Mind Springs “focus on improving the system rather than on talking about their awards.”

Routt County has been changing some of its contracts with Mind Springs from a flat fee to an hourly rate so, as Commissioner Melton tells it, “we actually pay for services that they’ve actually provided.”

In six months of interviews, no one — except for Sheriff FitzSimons — called to dismantle Colorado’s community mental health centers. But as the state prepares to launch a new cabinet-level department overseeing mental health care this summer, Melton and officials from counties across the state have been asking for laws and policies to make the centers more transparent and accountable.

Colorado’s Office of Behavioral Health Director Robert Werthwein has been outspoken about the need for those changes. “Let’s just say, and I’m trying to be diplomatic, that a lot of work needs to be done,” he said over the summer about Mind Springs in particular. He will not be there to help make reforms because he will be resigning in February.

Robert Werthwein will step down in February as director of Colorado's Behavioral Health Office. He has been an outspoken advocate of requiring more transparency and accountability of Mind Springs and other community mental health centers statewide.
Marc Piscotty/Courtesy photo

At his home in Summit County, Travis Bickford says Coloradans cannot wait for state bureaucrats and lawmakers to resolve their “infighting and politicking and BSing” about mental health policy, especially while the pandemic is still adding to the reasons people are spiraling into crises.

“People need help now, yesterday, six years ago. How many suicides … should it take to fix things?” Bickford said.

On the wall of his living room, Bickford keeps two framed photos of his late wife, Jackie. One is from their wedding day and the other from the last day their family of three spent together. He often pulls that photo down to look at it more closely and think about what was and what could have been. He tries, hard, to cut through the anger and hurt about her death and let himself feel what it is to just miss her.

Breckenridge resident Travis Bickford and his son, Trent, pose at the Swan Mountain overlook in Summit County on Sept. 7. Bickford holds a picture of his late wife, Jackie.
Joel Wexler/For the Summit Daily News

New CMC programs help meet rising need for addiction technicians and specialists

Luke Lubchenco, a student of CMC's new certified addiction technician program, is pictured Tuesday, Aug. 31, outside Valley View Hospital in Glenwood Springs, where he is a mental health advocate at the Youth Recovery Center.
Rich Allen/Post Independent

GLENWOOD SPRINGS — A pair of new Colorado Mountain College programs are turning around certified addiction technicians and specialists at a high rate as the need continues to grow.

The new programs launched Aug. 24 for a cohort of six individuals, the first of 15 weeks of coursework, which CMC officials said is the fastest in the state to fulfill classroom qualifications to apply for the two certifications. It also allows students to receive college credit as they train to begin or further careers in addiction treatment. They open the door to higher qualifications, which means higher wages, and further education like a master’s degree in an essential field that is only seeing demand increase.

“The more I learn about addictions, the more I see that it’s undervalued, underserved and extremely stigmatized,” said Luke Lubchenco, a student of the new program.

Lubchenco is a mental health advocate at the Youth Recovery Center at Valley View Hospital in Glenwood Springs. He’s been there for nine months providing support for the kids and families going through the program. He was driven to be part of the solution after seeing addiction impact those around him growing up.

To Lubchenco, the new programs allow him to turn his desire to help into a legitimate career.

“In the short term, it will certainly open doors to greater compensation,” Lubchenco said about the certification. “It also sets up for the long term, applying for grad school. It opens a lot of doors to anywhere you want to go with addictions.”

Certified addiction technicians and specialists offer support and treatment for people who have substance use disorders and their families. A technician works at the entry level, including collecting screening data and providing education, while a specialist is a higher-level qualification that deals more directly with treatment. Both require classroom learning and field work.

The state of Colorado renamed the certificates last year and added a bachelor’s degree requirement in the areas of addiction, behavioral analysis or mental health for the specialist role. According to Colorado Mountain College Dean Anne Moll, the state wants people in these roles to be educated to a certain level, specifically on a trajectory for a master’s degree.

CMC, already laying the foundation for the program, had to adapt its programming some but ultimately found the changes to be “exactly what we want,” Moll said.

“We had planned it, but we had to adjust a little bit to build it out with the bachelor’s,” she added. “We wanted to support what the community needed, and now we get the opportunity to do that even more so because we were planning this bachelor’s all along.”

The idea is that earning a degree and putting students on a path to more education will help elevate them above minimum-wage support jobs, earn higher pay and increase quality of care for patients in recovery.

CMC began exploring the idea of creating a college program several years ago. Community members reached out looking for ways for their employees to be compensated through college credit for undergoing the training to be certified. Now, with the program underway, Moll said the program hasn’t had to advertise as more groups have approached the school with interest in sending employees or even duplicating the cohort model for their workers as demand in the field increases.

There are up to 250 open positions for addiction counselors in Colorado, Moll estimated. The Bureau of Labor Statistics estimates the field will add up to 80,000 jobs nationally by 2029, a 25% growth from 2019.

In the wake of the pandemic, the need became immediately apparent. CMC counselor Chris Harnden said that following a huge flatline in counseling referrals during the shutdown, those referrals spiked once society started opening back up.

Many of those cases had a substance use aspect.

“People had sought comfort, in a time of uncertainty, in drugs and alcohol because that’s what they could get their hands on,” Harnden said. “Now they’re coming out of this, and they have no coping skills. They haven’t practiced them in over a year.”

In the coursework, the students are learning about ethics, counseling skills, culturally informed treatment and motivational interviewing. They are being taught to treat with compassion and understanding.

Harnden said other schools offer college credit for training to be certified, but CMC is the first to allow students to complete the coursework in a semester, shrinking the curriculum from two years down to four months. The students still have to complete 1,000 hours of clinical work before they can apply for the certification but can have the in-class aspect done at an accelerated pace.

He said no material was cut — students just meet for extended classes twice a week. Curricula for each certification have 11 courses, adding up to 12 to 15 credit hours.

Lubchenco lives in Carbondale and said two of his classmates are from Rifle and one is from Leadville. Moll said much of the interest came from the Silt-to-Rifle region. And through community outreach, she learned there is a demand for these solutions at the local level. The program incentives locals to pursue these higher levels of qualification and stay in the field.

“We need people who are from our communities, who will stay in our communities,” Moll said. “I think it gives us a great opportunity to really help and significantly put a dent in the needs of our communities.”

Regenerative Medicine provides new hope and healing

Regenerative medicine using orthobiologics can provide significant results for patients suffering from conditions like osteoarthritis, helping them to get back to the activities they love. (Getty Images)
Regenerative medicine using orthobiologics can provide significant results for patients suffering from conditions like osteoarthritis, helping them to get back to the activities they love. (Getty Images)

In the last decade, interventions involving orthobiologics, like platelet rich plasma (PRP), have been providing relief and new hope for tissue and joint damage. Many patients with conditions like osteoarthritis, degenerative disc disease and tendinosis are finding significant, long-term improvement from orthobiologics — the use of natural substances like platelets and stem cells to help musculoskeletal injuries heal. 

Dr. Matthew Gnirke, a physiatrist at Vail-Summit Orthopaedics & Neurosurgery, specializes in orthobiologics. He employs PRP and bone marrow aspirate concentrate (BMAC) to get people back to the sports and activities they love.

What is it?

PRP and BMAC both use platelets from the patient’s own body. 

PRP interventions involve a simple blood draw — about 60cc, which is anticoagulated (to prevent blood clotting) and spun to separate different cell types. Physicians then collect the platelets, which are the least dense cells, and inject them into a joint or other damaged site. 

BMAC interventions also use platelets, along with a small amount of stem cells; these mesenchymal stem cells have the ability to differentiate (or turn into) cells that produce cartilage, tendons, ligaments and muscles. They are sourced from bone marrow through a needle. The procedure can be done in office, or, if a patient prefers sedation, in a surgical setting.

“BMAC is not a surgical procedure, but it can cause pain,” he said. “The response is highly variable. Many patients describe it as a deep Charlie horse in the buttock. Some feel it less, some more, but the vast majority of patients do tolerate it in the office and sedation is not necessary.” 

BMAC is often used for more advanced osteoarthritis and disc diseases, whereas PRP is used for early stage osteoarthritis, joint issues and tendon disorders like tendinosis (the latter of which is caused by degeneration of a tendon’s collagen from chronic overuse, such as “tennis elbow”).

Platelets act like microscopic, natural “surgeons,” Gnirke said. They attach to damaged collagen fibers, which are the fundamental building blocks of tendons, ligaments and muscles. One platelet contains over 1,200 growth factors within it, he said. PRP treatment typically releases at least 1 million platelets into an injured area, releasing growth factors involved in collagen repair and synthesis. 

“They are truly wound-healing cells,” Gnirke said.

What can it help?

Orthobiologics are referred to as regenerative medicine because they actually help heal rather than simply masking symptoms like steroid shots do. They are used to treat damaged tendons, ligaments, muscles, joints and discs. 

Gnirke has seen patients with early stage osteoarthritis of the knee and other joints, as well as conditions like tennis elbow, improve significantly. These conditions result from slow degradation over time, as collagen fibers lose strength and density and tend to get microtears.

“The earlier you catch it, the more likely you’re able to see long term trajectory changing improvement,” he said. 

Dr. Matthew Gnirke (photo courtesy of Vail Summit Orthopaedics & Neurosurgery)
Dr. Matthew Gnirke (photo courtesy of Vail Summit Orthopaedics & Neurosurgery)

He recommends people come in for an evaluation as soon as symptoms affect them regularly or impact function. Even if you can still ski, bike, hike and do what you love, if you’re modifying movements or aware of discomfort, it often indicates mild to moderate disease, he said. Grinning and bearing pain or stiffness could lead to further breakdown of tissues and joints, which can progress to more severe osteoarthritis (like bone on bone knee damage) or severe disc degeneration and associated pain.

Gnirke finds orthobiologics “quite effective for lower back pain related to degenerative disc disease,” he said. “Studies show an improvement in back pain in two out of three patients over the long term.”

In the past, physical therapy and/or anti-inflammatories, then surgery was used to treat degenerative disc disease — there weren’t many options in-between. Orthobiologics bridge that gap.

Originally used in sports medicine for professional athletes, PRP and BMAC are now available to the general public. Though most insurances still view them as experimental treatments, workman’s compensation insurance and Kaiser Permanente are paving the way for other companies to cover the procedures. No one knows when (or if) that will happen, but it’s still probably years away. Until then, patients can pay out of pocket (usually under $1,000 for PRP).

Studies show that 65% to 75% of patients respond positively to PRP and BMAC.

“Over 2/3 of patients see significant, long-term improvement for greater than one to two years,” Gnirke said.

How the procedure works

Once platelets (and stem cells, in the case of BMAC) are collected, Gnirke delivers injections into the site of injury, using ultrasound or x-ray to ensure the exact site of injection.

Patients often temporarily feel worse before they get better: Pain flare ups range from mild to severe and can last anywhere from one day to up to two weeks. The longer, more severe reactions usually occur with spinal injections, he said. Within a month, patients usually feel they’re at baseline: not better, not worse.

Typically, it takes about six to eight weeks to start feeling improvement; it can take four to six months, and even up for a year if it’s a spinal injection, for improvements to fully take effect. Of course, regenerative medicine is just one of the procedures Gnirke employs. His practice focuses on proper diagnosis, prevention, treatment and rehabilitation of musculoskeletal injuries and disorders. He avoids overtreating and doesn’t believe in preemptive orthobiologics where they’re not needed. His main interest: getting people back to doing what they love.

Learn More

To find out more about regenerative medicine and Dr. Matthew Gnirke, visit vsortho.com

As restrictions loosen, some people are hesitant about returning to pre-pandemic life

Summit County resident Stephanie Trasatti looks out her window in Dillon on Thursday, May 13. She is one of many people who are feeling hesitant about pandemic restrictions loosening in the community.
Photo by Ashley Low

While many are breathing a sigh of relief at the loosening of local restrictions, some are feeling hesitant and are questioning whether the county is moving too quickly.

On May 4, the county officially moved into level green, removing the 6-foot distancing rule and capacity restrictions. On Friday, May 14, the county was working to update its public health order to better align with the state’s in addition to new guidance on mask-wearing from the Centers for Disease Control and Prevention.

As the county quickly drops restrictions that have become a part of everyday life for the past 14 months, some residents, including Stephanie Trasatti, are taking pause and wondering if this is the right move.

Trasatti is a nurse who works at St. Anthony Summit Medical Center and has helped take care of COVID-19 patients. Because of her job, and because she has underlying health conditions, she said she has significantly reduced her social circle over the past 14 months and limited how much she’s in public.

“I feel like I’ve also had to cut out certain people, friends who are not as cautious as maybe some other people, which has made my friends group very small,” Trasatti said. “(They’re) people I trust to hang out with. But that, in turn with the restrictions everywhere, has left me sitting at home a lot and totally changed my entire lifestyle.”

Since the pandemic began, Trasatti has canceled four trips to visit family and said she felt anxiety about attending her brother’s wedding. She said she continues to feel hesitant about traveling and being in large groups of people.

Now that life is slowly returning to normal, Trasatti said she’s nervous about transitioning to life post-pandemic, especially as mask requirements loosen.

“Almost going out without a mask on, you just feel so exposed and so vulnerable. And COVID’s not gone, so it makes it difficult,” Trasatti said. “You want to trust that they’re doing this for a reason, and they’ve done their research, but I feel like masks have almost become a security blanket, and it just makes you anxious because you could get sick. Your risks of getting sick are a lot higher being around people, and you don’t have that shield.”

Summit County resident Stephanie Trasatti works from her home in Dillon on Thursday, May 13. She is one of many people who are feeling anxious about pandemic restrictions loosening in the community.
Photo by Ashley Low

Breckenridge resident Patricia Walker said she also isn’t sure whether the county is heading in the right direction.

“I’m not too sure we’re handling the relaxations very well,” Walker said. “I personally — as much as I hate wearing this mask, and trust me, I hate wearing this mask — I would rather wear this mask until (COVID-19) is completely gone.”

Walker said her life dramatically changed, too. Walker typically sees her husband six months of the year because he travels for work. When the pandemic hit, both of them were in different parts of the country and neither was willing to travel to see the other. Until recently, Walker hadn’t seen her husband since January 2020.

Though she’s visited a couple of restaurants, socialized with friends who are vaccinated and traveled some, Walker said she’s still hesitant to be in public without a mask.

Rachel Miller, mental health supervisor at the Family & Intercultural Resource Center, said she primarily sees individuals who are struggling with one of two responses: in some instances, Miller said individuals experience physical symptoms of anxiety and might be having a trauma-like response when reentering society. In other instances, individuals are trying to forge ahead and are questioning what normal looks like for them.

Miller said it’s important to establish practices that remind you you’re safe in the present moment. Activities like exercising, being outside, gardening, meditation, meaningful connection with loved ones and journaling are all coping strategies she suggested. Above all, Miller said it helps to validate feelings of stress in most cases.

“I just want to normalize that people are feeling that way, and sometimes just normalizing it is what we need to hear to move through it,” Miller said. “You’re not the only person feeling that way.”

Summit County resident Stephanie Trasatti takes her dog for a walk in Dillon on Thursday, May 13. She is one of many people who are feeling anxious about pandemic restrictions loosening in the community.
Photo by Ashley Low

On Thursday, May 13, Building Hope Summit County hosted a virtual event that focused on anxiety reentering society. Jane Hahn of Grit Therapy led the event and provided some tips and coping strategies for attendees to try as they begin participating in social activities again.

Some of her strategies included starting small, like mingling in a small group of people outside, and getting a “COVID reentry buddy,” or another person who feels similarly to you so that the two of you can try activities together.

Hahn also suggested separating caution and fear, setting boundaries with family and friends about what you are and are not OK with, limiting news intake, participating in virtual social events and going to therapy if anxiety is impacting your sleep or appetite.

At a glance

Tips for managing reentry anxiety

• Start small: Socialize with a small group of people outside before attempting to socialize in large groups or indoors

• Get a reentry buddy: This person could be someone who has similar feelings as you who you can reenter society with

• Separate caution and fear: Are you staying home out of necessity or because of anxious or fearful feelings?

• Stay connected: Continue participating in virtual social events

• Get help: Go to therapy if negative feelings are disrupting sleep or causing loss of appetite

More personalized, accurate knee surgery with robotics

ROSA provides surgeons with scientific data and precision that leads to improved outcomes for patients who undergo total knee replacement. (photo courtesy of Vail Summit Orthopaedics & Neurosurgery)
ROSA provides surgeons with scientific data and precision that leads to improved outcomes for patients who undergo total knee replacement.
Photo courtesy of Vail Summit Orthopaedics & Neurosurgery

Vail-Summit Orthopaedics & Neurosurgery has always been a leader in cutting edge surgery, and now it’s providing more personalized and even more accurate total knee replacements with its Zimmer Biomet Robotic Surgical Assistant (ROSA). 

Increased precision and data

Dr. Nathan Cafferky recently published a paper highlighting the benefits of using ROSA in the peer-reviewed journal “Case Reports in Orthopedics.” His study, which included five total knee replacements, showed how ROSA allows surgeons even more precise knee implant positioning by using real-time, scientific data to guide the accuracy of the surgeon’s work. For instance, ROSA lets surgeons know that the tension they place on each of the ligaments is exact and helps them make more pure bone cuts. Before ROSA, surgeons used their medical expertise to determine if ligament tension was appropriate.

“Historically, surgeons have relied on their training, and have used a more subjective artistic approach to evaluation the ligamentous tension,” Cafferky said. “ROSA provides the surgeon with real-time objective data on the ligamentous balancing and gives the surgeon scientific confidence that the knee replacement is well balanced and personalized to each individual patient.”

“Conventional and robotic total knee replacement surgeries are very good at restoring alignment, but total knee replacement is functionally a soft tissue balancing surgery, so it comes down to what the surgeon feels is acceptable. Each surgeon’s assessment of a knee may feel different during surgery, but with robotics, we’re putting numbers on that feel,” Cafferky said. “I think that has been the missing link in total knee replacement surgery.”

Better patient outcomes

Prior to surgery, ROSA converts x-rays — rather than an expensive MRI or a high-radiation CT scan — into a three-dimensional representation of the knee. This allows physicians to map out a patient’s exact, and unique, anatomy before operating. 

The robotic data is especially important for patient satisfaction. Though most patients do very well with total knee replacements, nationwide, about 15% to 20% express pain, discomfort, mechanical sensations or stiffness. Granted, only about 10% of VSON patients express such dissatisfaction, but with ROSA, that number is expected to decrease.

Cafferky notes that ROSA helps provide a more scientifically balanced total knee, leading to highly satisfied patients who are able to successfully return to the activities they love, like skiing, hiking and cycling.

“Our patients already do better than national outcomes, but with robotics, we’re looking to do even better,” Cafferky said. “We’re seeing patients recover faster with less soft tissue trauma and not as much bleeding. Patients have a faster get up and go, faster range of motion improvements and less need for post op manipulations. They appear to be performing better than conventional total knee replacements and have a better quality of life, as far as athletics.”

So far, short-term recovery seems faster and patients appear more satisfied long term, but Cafferky will continue to follow up with long-term outcome studies.

“We’ll probably see faster recovery short-term, and more reproducible long-term outcomes, meaning a higher percentage of patients get back to a more satisfying lifestyle. However, prospective studies (are necessary) to see if we have scientific, statistically significance comparing conventional total knee replacement patients to ROSA assisted total knee replacement surgeries, because we are only a year into our study right now,” he said. “I’m actively involved in multi-center studies, looking at our patients’ outcomes.”

Leading the development of innovative surgical technology

Dr. Cafferky has been on the cutting edge of robotic surgical assistant technology; even before the FDA cleared it for use in total knee replacements in January 2019. He is a consultant for Zimmer Biomet and helped Zimmer Biomet evaluate the safety and accuracy of the ROSA total knee replacements through cadaveric studies and evaluations, which ultimately led to FDA approval in January of 2019. 

“ROSA was initially designed to be used in neurosurgery, due to its very small — 0.5 millimeter — margin of error, meaning that it is very safe,” he said. “My job in the early phases of cadaveric evaluation was to try to turn a Neurosurgery Robotic Arm into an Orthopaedic Robotic Arm. With great success, the FDA approved the ROSA in January 2019, and thus our patients at Vail Summit Orthopaedics and Neurosurgery are benefiting from this technology.”

In April 2019, Vail Health purchased the Zimmer Biomet ROSA, making it one of the first in the nation to acquire the technology. By the first week in May 2019, Cafferky had successfully completed his first robot-assisted total knee replacement. 

About Nathan Cafferky, M.D. FAAOS

As a total joint surgeon who specializes in adult reconstruction, Dr. Cafferky focuses on hip and knee replacements at Vail-Summit Orthopaedics & Neurosurgery. A native of Portland, Ore., Dr. Cafferky attended medical school at Loma Linda University School of Medicine in Southern California and completed his residency and fellowship training in joints and adult reconstruction at the University of Colorado Anschutz Medical Campus. He serves as a U.S. Ski Team physician and a Team Summit Colorado physician.

“I was one of the first users in the country, and world, to adopt this technology and have been seeing our patients benefit since,” Cafferky says. “Other surgeons from around North America, and around the globe are also seeing the benefits, and many visiting surgeons are coming to Vail to learn how we are improving our patient experience with ROSA.”

Cafferky has trained surgeons from across the United States and around the globe as they launch ROSA technology in their communities.

“It’s been a great privilege and experience to get to interact and train surgeons from around the world. Not only do I get to teach others, but these surgeons also get to teach me something as well,” he said.

ROSA, which is comprised of a base unit with a robotic arm, can position cutting guides for the most accurate bony cuts, and provide objective information on the ligamentous balancing at each step, but Cafferky is still doing and performing the surgery. Cafferky likens surgery before and after ROSA to “going from paper maps to GPS.”

“The most exciting aspect is the objective data I get during surgery,” he said. “The experience is much more streamlined, scientific, and more personalized. Now I can tell a patient with confidence that ‘your knee is scientifically balanced and personalized for you’. I have scientific evidence to support that.”

State border-jumpers can get vaccinated in Colorado — even if no one’s happy about it

 

DENVER — In Aspen, a group of 20 Brazilians planned to hang out in a rented vacation home in the picturesque ski town for a few weeks this winter while they got two rounds of coronavirus vaccine.

In Delta County, tucked in the western Colorado mesas, gobs of people from Michigan and Texas have signed up for vaccine appointments — most likely because they were confused and thought they were registering in Delta County, Michigan, or Delta County, Texas.

And in Steamboat Springs, locals are pointing fingers at second-home owners who buzzed into town to collect a shot, concerned that those part-time Routt County residents might have jumped ahead in line.

This all is perfectly fine, according to state officials.

According to the state’s rules, it doesn’t matter what county, state or even country a person lives in when they sign up for a vaccine appointment, as long as they meet the criteria for Colorado’s current phase in the immunization priority list.

Colorado is not requiring identification, proof of address or proof of citizenship to get a vaccine — the state does not want to add any barriers to those whose turn is up, Gov. Jared Polis said Tuesday. Besides, Coloradans who live on the edges of the state are driving across the borders to Wyoming, Texas and elsewhere to get vaccinated. Polis figures it all evens out.

Read more at ColoradoSun.com.

Summit County officials to change public health order, giving short-term lodging companies more leeway

Townhomes at the base of Peak 8 in Breckenridge are pictured Nov. 20. Many of the residences in Breckenridge are used as second homes and for short-term rentals. Photo by Jason Connolly / Jason Connolly Photography

Summit County officials will be releasing a new public health order next week to clarify how short-term lodging companies should go about confirming the number of households in one reservation.

Summit County Manager Scott Vargo announced the change at a Board of Health meeting Thursday, Jan. 14. Vargo said the new order likely won’t go into effect until Friday, Jan. 22, to allow for lodging companies to adjust.

The current order states that “owners and/or entities responsible for the booking and renting of short-term lodging units must confirm the identity of all renters upon arrival” to ensure that the group doesn’t violate the state’s public health order, which limits gatherings to two households under level orange restrictions.

The proposed language for the new order says short-term lodging companies must “confirm renters are aware of and are in compliance with gathering size limits” mandated by the state’s public health order.

The goal of the change is to simplify the process for confirming customers’ identities. Under the current order, short-term lodging companies are liable if a guest breaks public health rules. The change will put that liability on the guests instead.

“The change is trying to clarify what the expectation is and simplifying how property managers, property owners, are able to verify or confirm the folks that are renting those properties are aware of the rule and in compliance with the rules,” Vargo said.

The county also created a sample form for short-term lodging companies to give to guests ahead of arrival. The form requires the person who made the reservation to certify that they have reviewed the local and state public health order and are aware that a violation could mean a fine of up to $5,000 or up to 18 months in jail.

“They don’t have to use this form, but I would suspect that most will take advantage of something that’s been prepared or take the language from this form and plug it into whatever electronic system that they may be using or other check-in model that they’re taking advantage of,” Vargo said.

At a Board of Health meeting on Thursday, Jan. 14, Summit County Manager Scott Vargo presented a sample form for short-term lodging owners and managers to use to confirm that guests are aware of COVID-19 rules.
Screenshot from meeting

Commissioner Tamara Pogue said the goal of the change is to make the process as easy as possible for lodging companies.

“The idea is they’ll not be required to look for any more form of ID from their guests,” she said. “By asking their guests to sign the affidavit, it limits and mitigates some of the liability to the personal company if folks choose to misrepresent what is actually happening.”

County officials also hope the change will create some parity between what the county is doing for lodging companies and the rules for restaurants, which are not required to confirm the identity of guests unless they are five-star certified.

At the meeting, Vargo also said the county will not be making adjustments to alcohol-consumption rules for restaurants that are in the 5 Star Business Certification Program for at least a week.

Currently, all restaurants must cease the sale and consumption of alcohol at 9:30 p.m. However, some restaurant owners are pushing for the county to allow alcohol to be on a table until 10 p.m. at five-star certified restaurants.

Because the county is in the midst of a bump in cases due to the holidays, officials are putting a pause on making that change.

“Our recommendation from staff and from (Public Health Director Amy Wineland) is that we push and wait and see where do those numbers go?” Vargo said. “Do we start to settle back down? Or do we start to see that trend continuing to go up?”

Wineland said the county should know by Thursday, Jan. 21, whether the bump in cases has been suppressed.

Pogue said she hopes the county will be able to make the change sooner rather than later.

“I really don’t want to drag this on,” Pogue said. “I don’t think there’s great data to justify the change from the state’s restriction in this space.”